Expandable corpectomy cage

ABSTRACT

A surgical implant is provided with upper and lower telescoping members which move axially between extended and retracted positions. A fixed length sleeve fits over the telescoping members. The sleeve is load bearing to support axial loads. The sleeve also prevents the telescoping members from retracting and encloses an internal cavity within the implant for packing bone fusion material.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of application Ser. No.13/409,357, filed Mar. 1, 2012, which claims priority to Application No.61/448,981 filed Mar. 3, 2011, all of which are hereby incorporated byreference in their entireties.

FIELD

The invention relates to an expandable corpectomy cage having non-weightbearing telescoping members which are expandable and retractable and aweight-bearing sleeve fit over the telescoping members so that thesleeve bears axial loads when the assembled cage is implanted in apatient.

BACKGROUND

A corpectomy is a surgical procedure wherein a portion of the vertebralbody and adjacent intervertebral discs are removed to relieve pressureor decompress the spinal cord and nerves. A corpectomy cage is used tofill the space created by the vertebrae removal. Two types of cages aregenerally available: A solid fixed height cage and an expandable cage.Fixed cages are manufactured in various heights so that one cage can beselected to best fit the cavity created by the removed vertebral body.Alternatively, an expandable cage having a variable height can be usedto maintain spacing of the vertebrae above and below the removed bodymaterial. Such expandable cages typically include telescoping memberswith a physical mechanism to retain the members at the selected height.For example, telescoping members are formed with threaded or ratchetinginterconnections, or the use of pins, set screws and the like, to fixthe members at a selected height.

Both types of cages have limitations and problems. Fixed or solid cageshave excellent structural integrity, but are cumbersome to place. Thefixed cage must be exactly the right height. Otherwise, if the cage istoo big, it can cause over distraction to the vertebral bodies or damagethe vertebral body above and below the cage. If the cage is too small,it can move out of position. Expandable cages are much easier to placeand size correctly. However, the mechanical mechanism used to expand thecage may fail in vivo, which can lead to catastrophic results. Thetelescoping members are weight bearing so as to support the axial loadson the cage when the cage is implanted. Thus, the strength of the casedepends upon the inner connection between the telescoping members. Ifthe physiologic load becomes too great, the cage will collapse, therebycausing potentially serious medical problems for the patient. Thus, thestructural integrity of an expandable case is less than a fixed or solidcage.

Some commercially available expandable cage are made of metal. Thesemetal cages cause artifact on MRI or CT scans, thereby decreasing theability to visualize nearby anatomy. Metal cages are also much harderthan bone, and can telescope into the vertebral bodies above and belowthe cage. Commercially available fixed cages are made of othermaterials, such as carbon fiber, or plastic, which eliminate artifactson MRI and CT scans.

Accordingly, a primary objective of the present invention is theprovision of an improved expandable corpectomy cage which overcomes theproblems of the prior art.

Another objective of the present invention is the provision of anexpandable corpectomy cage having structural integrity and which is easyto use.

Still another objective of the present invention is the provision of anexpandable corpectomy cage which is made of non-metallic materials so asto avoid scanning and imaging artifacts.

Yet another objective of the present invention is the provision of acorpectomy cage having telescoping members which are non-load bearing,and a load-bearing sleeve around the telescoping members.

A further objective of the present invention is the provision of acorpectomy cage having C-shaped telescoping members with alignedopenings for receiving bone fusion material, and a sleeve to cover theopenings so as to retain the fusion material within the cage.

Still another objective of the present invention is the provision of animproved corpectomy cage having minimal weight and increased strength.

A further objective of the present invention is the provision of animproved corpectomy cage which is economical to manufacture, and safeand durable in use.

These and other objectives will become apparent from the followingdescription of the invention.

SUMMARY

The expandable corpectomy cage of the present invention includes upperand lower telescoping members or segments which are movable axiallybetween extended and retracted positions. Each segment has an internalcavity for receiving bone fusion material. A C-shaped sleeve or coverremovably fits over the opening in opposite sides of the telescopingmembers. The primary function of the sleeve is to support axial loads onthe assembly to prevent the telescoping members from retracting orcollapsing. The sleeve also encloses the cavity, which is free fromobstructions. The sleeve is retained on the telescoping members by asnap fit, fasteners, or other locking means. The assembly may have asubstantially square cross-section or a circular cross-section.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-14D of the drawings show a first embodiment of the corpectomycage of the present invention having a square cross-section.

FIGS. 15-21 show a second embodiment of the corpectomy cage of thepresent invention having a round cross-section.

FIG. 1A is a perspective view of the first embodiment of the corpectomycage according to the present invention.

FIG. 1B is a perspective view of the telescoping members of the firstembodiment.

FIG. 2 is a sectional view taken along lines 2-2 of FIG. 1A.

FIG. 3 is an exploded view of the telescoping members and sleeve of thecorpectomy cage of the first embodiment.

FIG. 3A is an exploded view of an alternate embodiment with ratchetingside walls on the telescoping member.

FIG. 4 is a plan view from one side of the cage.

FIG. 5 is a sectional view taken along lines 5-5 of FIG. 4.

FIG. 6 is a perspective view of a shortened sleeve for the corpectomycage.

FIG. 7A is a perspective view of the inner telescoping members.

FIG. 7B is an end view of the inner telescoping members shown in FIG.7A.

FIG. 7C is an elevation view of one side of the inner telescopingmember.

FIG. 7D is an end view from the opposite end of FIG. 7B.

FIG. 7E is another elevation view of the inner telescoping member.

FIG. 8A is a perspective view of the outer telescoping members.

FIG. 8B is an end view of the outer telescoping members shown in FIG.8A.

FIG. 8C is an elevation view of one side of the outer telescopingmember.

FIG. 8D is an end view from the opposite end of FIG. 8B.

FIG. 8E is another elevation view of the outer telescoping member.

FIG. 9A is a perspective view of the sleeve of the corpectomy cage.

FIG. 9B is a top plan view of the sleeve.

FIG. 9C is an elevation view from one side of the sleeve.

FIG. 9D is an elevation view from another side of the sleeve.

FIG. 10 is an exploded view of an alternative embodiment of thecorpectomy cage.

FIG. 11 is a perspective view of a shortened sleeve for the cage of FIG.10.

FIG. 12A is a perspective view of the inner telescoping member of thecorpectomy cage shown in FIG. 10.

FIG. 12B is an end view of the inner telescoping members shown in FIG.12A.

FIG. 12C is an elevation view of one side of the inner telescopingmember shown in FIG. 12A.

FIG. 12D is an end view from the opposite end of FIG. 12B.

FIG. 12E is another elevation view of the inner telescoping member ofFIG. 12A.

FIG. 13A is a perspective view of the outer telescoping member of thecage shown in FIG. 10.

FIG. 13B is an end view of the outer telescoping members shown in FIG.13A.

FIG. 13C is an elevation view of one side of the outer telescopingmember shown in FIG. 13A.

FIG. 13D is an end view from the opposite end of FIG. 13B.

FIG. 13E is another elevation view of the outer telescoping member ofFIG. 13A.

FIG. 14A is a perspective view of the sleeve of the corpectomy cageshown in FIG. 10.

FIG. 14B is a top plan view of the sleeve of FIG. 14A.

FIG. 14C is an elevation view from one side of the sleeve shown in FIG.14A.

FIG. 14D is an elevation view from another side of the sleeve of FIG.14A.

FIG. 15 is a perspective view of the round embodiment of the corpectomycage of the present invention.

FIG. 16 is another perspective view of the round corpectomy cage.

FIG. 17 is an exploded view of the round corpectomy cage.

FIG. 18 is an enlarged view taken along line 18 of FIG. 16.

FIG. 19 is a side elevation view of the round corpectomy cage.

FIG. 20 is a sectional view taken along lines 20-20 of FIG. 19.

FIG. 21 is a sectional view taken along lines 21-21 of FIG. 19.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A square embodiment of the corpectomy cage of the present invention isdesignated by the reference numeral 10 in FIGS. 1A-14D. FIGS. 15-21 showa round embodiment of the corpectomy cage designated by the referencenumeral 10A. The cage 10 has three primary components: an innertelescoping member 12, and outer telescoping member 14 and a sleeve orcover 16. Similarly, the cage 10A has three primary components: an innertelescoping member 12A, an outer telescoping member 14A, and a sleeve orcover 16. The cages 10 and 10A, and their components, function similarlyto one another in implantation and in use.

The inner telescoping member 12 has opposite sides 18 with an innerconnecting web or back wall 20, with an opening 22 opposite the web 20.Thus, the inner telescoping member 12 has a general C-shape with squaredcorners. The outer telescoping member 14 has opposite sides 24, with aninner connecting web or back wall 26, with an opening 28 opposite theweb 26. Thus, the outer telescoping member 14 has a C-shape with squaredcorners. The sidewalls 18 of the member 12 have a narrower spacing thanthe side walls 24 of the member 14, such that the members 12, 14 can beassembled for axial movement relative to one another.

In the alternative embodiment shown in FIG. 3A, the sides 18 haveexternal ratchets 19 and the side 24 have internal ratchets. Theratchets 19, 24 matingly overlap and allow the telescoping members to beextended one step at a time, such as 1 mm increments.

The inner and outer telescoping members 12A, 14A each have cylindricalside walls 18A, 24A, respectively, with enlarged openings therein. Thediameter of member 12A is smaller than the diameter of member 14A, sothat the members can be assembled for axial movement relative to oneanother.

The sleeve 16 includes opposite sides 30 with a web or front wall 32extending between the opposite sides, and an opening 34 opposite the web32. The sleeve 16 has a C-shaped profile with squared corners.Similarly, the sleeve 16 has opposite sides 30A with an opening 34A.

The inner and outer telescoping members 12, 14 each have an end plate36, 38, respectively. Similarly, the inner and outer round telescopingmembers 12A, 14A have respective end plates 36A, 38A.

The inner and outer telescoping members 12, 14 and 12A, 14A are adaptedto matingly and slidably fit together in a telescoping manner for axialexpansion and retraction. The sleeve 16 is adapted to matingly fit overthe outer telescoping member 14A, with the opposite ends of the sleeve16 engaging the inner surfaces of the end plates 36, 38. Similarly, thesleeve 16 is adapted to matingly fit over the outer telescoping member14A, with the ends of the sleeve 16 abutting the inner surfaces of theend plates 36A, 38A. This assembly of the inner and outer telescopingmembers and the sleeve forms the cage 10, 10A with the sleeve 16, 16being load bearing. Thus, with this cage configuration of the presentinvention, the sleeves 16, 16 bear the axial loads from the vertebralbodies on the end plates 36, 38 or 36A, 38A. The sleeves 16, 16 therebypreclude or prevent the telescoping members 12, 14 and 12A, 14A fromcollapsing or retracting in vivo relative to one another. Also, thesleeves 16, 16 eliminate the need for a fastener between the inner andouter telescoping members, as in the prior art, to fix the relativepositions of the telescoping members relative to one another. Thus, thetelescoping members 12, 14 and 12A, 14A are non-load bearing.

Preferably, the inner and outer telescoping members 12, 14 haveoverlapping or interlocking structure so that these members slideaxially without transverse separation. More particularly, in thepreferred embodiment, the inner telescoping member 12 has an externaltongue or lip 40 extending outwardly from each side 18. The outertelescoping member has internal grooves 42 on each side 24 to slidablyreceive the tongues or lips 40 on the inner telescoping member 12. Forthe round inner and outer telescoping members 12A, 14A, the circularshape controls the sliding axial movement of the members relative to oneanother.

The sleeve 16 can be retained on the telescoping members 12, 14 in anyconvenient manner. In a preferred embodiment, the sleeve 16 snap fitsonto the outer telescoping member 14. More particularly, the outertelescoping member 14 has an axially extending external projection orbead 44 with a beveled surface and a retention shoulder extending alongeach side 24. The sleeve 16 has an internal groove 46 along the insideof each side wall 30. The sides 30 of the sleeve are resilient such thatthe sleeve snap fits over the beads 44, which are matingly receivedwithin the grooves 46 of the sleeve 16. Thus, the sleeve 16 is retainedon the outer telescoping member 14 by the overlapping beads 44 andgrooves 46. The sleeve 16 can be removed from the outer telescopingmember 14 by spreading the sides 30 to disengage the beads 44 andgrooves 46.

In an alternative embodiment shown in FIGS. 10-14D, the sleeve 16 isretained on the telescoping members 12, 14 using screws 48 which extendthrough the sleeve and into threaded holes in the telescoping members12, 14. For the round cage 10A, the sides 30A of the sleeve 16 areresilient, such that the sleeve 16 can be snap fit over the telescopingmembers 12A, 14A.

It is understood that the sleeve 16, 16 is generally selected by thesurgeon performing the corpectomy from a set of sleeves having variousheights or lengths, such that the assembled cage 10, 10A will properlyfit between the upper and lower vertebral bodies. For example, FIGS.1A-4 show a longer or taller sleeve 16, while FIG. 6 shows a shortersleeve. Similarly, FIG. 11 shows a shorter sleeve compared to the longersleeve shown in FIG. 14A.

While the sleeve 16, 16 prevents the telescoping members 12, 14 and 12A,14A from being retracted toward one another, in another alternativeembodiment, the sleeve can prevent extension of the telescoping membersrelative to one another. For example, in the round cage 10A shown inFIGS. 15-21, the sleeve 16 has a radially directed lip 50 extendinginwardly from each end for receipt in a groove 42 on each telescopingmember 12A, 14A. The lips 50 of the sleeve 16 are received in thegrooves 52 of the telescoping members 12A, 14A to prevent the membersfrom expanding axially.

The cages 10, 10A of the present invention are implanted usingconventional methodology. For example, the tips of a hand held expandingtool are received in holes 54 in the end plates 36, 38 of thetelescoping members 12, 14, or in a perimeter groove 56 in the endplates 36A, 38A of the telescoping members 12A, 14A. After thetelescoping members 12, 14, 12A, 14A, are implanted and bone fusionmaterial is added to the cage cavity, the sleeve 16, 16 is placed overthe telescoping members so as to fix the height of the cage 10, 10A. Theaxial loads on the cage 10, 10A are then born by the sleeve 16, 16,rather than by the telescoping members 12, 14 and 12A, 14A. The cages10, 10A have enlarged fusion openings 58, 58A to accommodate bone growtharound and through the cage. The center cavity of the cage issubstantially unobstructed for improved or enhanced bone growth andfusion.

Since the sleeve 16, 16 has a fixed length so as to be load bearing, thetelescoping segments 12, 14 and 12A, 14A, as well as the sleeves 16, 16,can be made of non-metallic material which does not interfere orotherwise produce artifacts when scanned or imaged. Thus, the cages 10,10A can be made of any high strength, lightweight, biocompatiblematerial.

The invention has been shown and described above with the preferredembodiments, and it is understood that many modifications,substitutions, and additions may be made which are within the intendedspirit and scope of the invention. From the foregoing, it can be seenthat the present invention accomplishes at least all of its statedobjectives.

What is claimed is:
 1. A spinal implant comprising: a first member having a sidewall, a first end and a second end opposite the first end, the sidewall having a groove; a second member having a sidewall, a first end and a second end opposite the first end, the sidewall having a groove, wherein the side wall and the second end of the first member is at least partially disposed within the side wall and the second end of the second member in a telescoping, non-load bearing engagement to allow axial movement between extendable and retractable positions, wherein the first end of the first member is located opposite to the first end of the second member; and a sleeve configured to bear axial loads on the implant and having a fixed length, a first end, a second end, a first lip extending radially inward proximate the first end of the sleeve, and a second lip extending radially inward proximate the second end of the sleeve, the sleeve fit over the second member with the first lip engaging the groove on the first member and the second lip engaging the groove on the second member.
 2. The spinal implant of claim 1 wherein the sleeve is snap fit onto the second member.
 3. The spinal implant of claim 1 wherein the sleeve comprises resilient sidewalls such that the sleeve can be snap fit over the first and second members.
 4. The spinal implant of claim 1 wherein the first end of the first member, the first end of the second member, and the sleeve have a substantially round cross-section.
 5. The spinal implant of claim 1 wherein the sleeve has an axial opening for receiving the first member and second member.
 6. The spinal implant of claim 1 wherein the axial opening extends between the first end of the sleeve and the second of the sleeve.
 7. The spinal implant of claim 6 wherein the first member and the second member have a circular profile, and the sleeve has a C-shaped profile.
 8. The spinal implant of claim 1 wherein the sleeve is selected from a set of sleeves each having a different length.
 9. The spinal implant of claim 1 wherein the first member comprises an end plate disposed at the first end thereof, the second member comprises an end plate disposed at the first end thereof.
 10. The spinal implant of claim 9 wherein each of the end plates comprises a perimeter groove configured to be engaged by a tool.
 11. The spinal implant of claim 1 wherein the cover has a cylindrical shape.
 12. The spinal implant of claim 1 where the side wall of the first member and the side wall of the second member each have cylindrical shape.
 13. A surgical implant for use between a first bone and a second bone, the implant comprising: a first segment with a sidewall, a groove, and an end plate, the end plate configured to engage the first bone; a second segment with a sidewall, a groove, and an end plate, the end plate configured to engage the second bone; a cover with a fixed length, the cover having a first radial lip and a second radial lip extending inwardly and spaced apart from the first radial lip; the first and second segments being slidably assembled; and the cover removably coupled to the assembled first and second segments between the end plates, wherein the first radial lip engages the groove on the first segment and the second radial lip engages the groove on the second segment.
 14. The surgical implant of claim 13 wherein the cover has resilient side walls and snap fits onto at least one of the segments.
 15. The surgical implant of claim 13 wherein the cover is selected from a set of covers each having a different length.
 16. The surgical implant of claim 13 wherein the assembled first and second segments have an adjustable length until the cover is coupled to the first and second segments.
 17. The surgical implant of claim 13 wherein the cover is load bearing and the first and second segments are non-load bearing.
 18. A interbody spacer implant for use between a first bone and a second bone, the implant comprising: a first segment with a sidewall, a groove, and an end, the end configured to engage the first bone; a second segment with a sidewall, a groove, and an end, the end configured to engage the second bone; a cover with a fixed length, the cover having a first radial lip and a second radial lip extending inwardly, the first radial lip being spaced apart from the second radial lip; wherein the first and second segments are slidably assembled; and wherein the cover removably couples to the assembled first and second segments between the end, wherein the first radial lip engages the groove on the first segment and the second radial lip engages the groove on the second segment.
 19. The spinal implant of claim 18 wherein cover is cylindrical and includes an axial opening extending its length between a first end and a second end of the cover.
 20. The spinal implant of claim 19 wherein the first segment and the second segment have a circular profile, and the cover has a C-shaped profile and has resilient side wall for a snap fit engagement with the first and second segments. 